Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 016290 | NY |
NPI | 1316181696 |
---|---|
Provider Name | Maohllicia Carolus |
First Address | New Rochelle, NY 10805-1781 |
Second Address | New York, NY 10016-5439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2009 |
Last Update Date | 30/04/2009 |